If BRCA positive, they must decide whether to undergo risk-reducing surgery to remove their ovaries and fallopian tubes.

If BRCA positive, they must decide whether to undergo risk-reducing surgery to remove their breasts.

Just a few months ago, 42-year-old Maxine Grossman, PhD, faced all these decisions. Her mother had died of breast cancer at age 55. A close cousin on her father's side was diagnosed with breast cancer at age 33. And Grossman has an Ashkenazi Jewish background, increasing her risk of carrying the BRCA gene.

These risk factors -- relatives on both sides of the family with early breast cancer and her heritage -- make Grossman a prime candidate for the BRCA gene test. But it was hard for her to decide to get the test -- and hard for her to face the next set of choices.

Now there's more information to help women like Grossman make these choices. It comes from a long-term study of nearly 2,500 BRCA-positive women studied at 22 medical centers in the U.S. and Europe by University of Pennsylvania researcher Timothy R. Rebbeck, PhD, and colleagues.

Only 10% of the BRCA-positive women in the study underwent preventive breast removal. Over three years of follow-up, none of them got breast cancer. Over the same period, 7% of BRCA-positive women who kept their breasts got breast cancer.

Only 38% of the BRCA-positive women in the study chose to have their ovaries and fallopian tubes removed. These women had a significantly lower risk of both breast and ovarian cancer than women who did not have the surgery.

They also reduced their risk of death. Among women who underwent the procedure, known as risk-reducing salpingo-oophorectomy or RRSO:

3% died from any cause, vs. 10% of those who did not have the surgery.

2% died of breast cancer, vs. 6% of those who did not have the surgery.

0.4% died of ovarian cancer, vs. 3% of those who did not have the surgery.